In Maine regulations, there are three kinds of assisted living residences that offer a living space with full-time care for mostly elderly people and those with dementia:
1. “Assisted living programs” provide personal care services to people living in a community that resembles apartment buildings. The apartments have their own living rooms, but residents usually share a dining space.
2. “Residential care facilities” provide personal and health care services to people living in private and semi-private bedrooms. Residents usually share living and dining space.
3. “Private non-medical institutions” offer similar personal and health care services as above, but are funded through Medicaid. (See Financial Assistance below.)
Any of these may offer help with activities of daily living (ADLs) like eating and bathing, and instrumental activities of daily living (IADLs) like banking and housekeeping. They may also provide meals, care management, medication assistance, and nursing care.
Any of these residences may house people with Alzheimer’s disease or similar dementia (like vascular, frontotemporal, and Lewy body dementias) in special wings or units, or in whole buildings offering dementia care. Among the requirements for these “Alzheimer’s / dementia care units” are:
– weekly activities that incorporate improving gross motor skills (movement of arms and legs)
– social, outdoor, spiritual, and sensory enhancement activities
Alzheimer’s care is often called memory care, and these buildings’ designs and construction must follow certain rules that benefit people with dementia, like circular hallways for residents prone to wander. Additional training for staff is also required (see below).
There are 25 memory care homes in Maine. There are also 18 board and care homes, which offer the same services as assisted living in much smaller house-like settings, usually to fewer than eight residents at a time. For free help finding memory care to meet your family’s needs and budget, click here.
Assisted living in Maine is regulated by the state’s Department of Health and Human Services.
The average cost of assisted living with memory care per month in Maine is $6,180, which breaks down to about $74,160 annually. The state’s most expensive city for memory care is Portland, where the average cost is $7,880 per month and $94,560 annually. The least expensive place for memory care is outside Maine’s biggest cities—in rural areas like the highlands and Aroostook County, the average cost is $5,630 per month and $67,560 annually. Maine residents probably won’t be able to find more affordable memory care across the state border; New Hampshire, Maine’s western neighbor, is one of the most expensive states for memory care, at an average of more than $8,300 per month and $100,000 annually.
Maine cities and memory care costs:
|Maine Memory Care / Assisted Living Costs (updated Dec. 2020)|
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New residents in assisted living in Maine must be medically evaluated within 30 days of moving in, and then again at least annually. This assessment is usually done by a healthcare profession who works for the home, and the cost is typically part of what’s called a “community fee” that also covers up-front expenses like painting a new resident’s room. The assessment must include determining which activities of daily living (ADLs), like eating and bathing, and instrumental activities of daily living (IADLs), like managing medications and finances, your loved one needs help with. Medication requirements and whether nursing service is necessary would also be covered in the assessment.
Every assisted living residence in Maine must have a standardized contract for new residents that lists each service provided and the related cost, so there can be no surprises in billing later. Contracts must also include:
– Process for filing a grievance
– Tenancy obligations
– Admissions policy
– Resident rights
A packet must also be available to any potential residents that includes this information:
– Specifics on the type of assisted living program provided (see above)
– Licensure status
– Information and contacts for Maine’s Long Term Care Ombudsman
– Advocacy and state agency contact information
– Process for transfer and discharge
– Staff qualifications
It is possible to move into Maine assisted living homes on short notice, even those with memory care, but this is not a good idea. Finding the perfect home for your loved one takes time and effort. You’ll want to talk with other residents and staff, inspect the grounds, and investigate all your options before signing a move-in contract. Starting your search before the move is necessary also allows the person with dementia to have more say in where they end up.
You do not need a diagnosis of dementia to move into memory care in Maine. Dementia is difficult to diagnose, with varying symptoms and multiple types that can appear very similar. (For more on how dementia is diagnosed, click here.)
Someone may be denied admittance or evicted because of:
– care needs that cannot be met at the residence
– behavior that damages property or is dangerous to others
– failure to pay
The only requirements for room size are specific to Residential Care Facilities, where bedroom units for one person must be at least 100 square feet, or 160 square feet for two people. Two is the maximum number of people allowed in one unit in a Residential Care Facility. One toilet must be provided for every six people in a Residential Care Facility, and one bath or shower for every 15 people.
Memory care residences must have physical designs that are dementia-friendly. This means features like easily navigated layouts and hallways that run circular without coming to a dead end. Secure outdoor spaces that allow people with dementia to spend time in the open air have also been shown to be beneficial.
There are no required staffing ratios in Maine assisted living homes, except to say there must be adequate staff at all times to meet the needs of every resident’s service plan. At least one staffer must be on-duty and awake at all times. An on-site administrator, dietary coordinator, and pharmaceutical consultant must also be employed by Maine assisted living homes. Administrators must be licensed in assisted living or have at least five years of experience in a related field. Administrators must also complete state-approved training, with 12 hours annually of continuing education in a relevant field. Staff who work with residents with dementia must have had pre-service training provided by the residence, including 16 hours of orientation.
When moving into an assisted living home in Maine, every resident should be given a written document that explains the process for discharge or eviction. This is an important document you should be sure to file, because unfair evictions are a major problem for families with a loved one in memory care. Regulations say a resident can be evicted for these reasons:
– Intentional behavior that damages property
– Medical needs that cannot be met at the residence
Unlike other states, Maine does not require the home to assist in finding a new place for your loved one to live. Fortunately, resources are available to help. For information on what to do after receiving an eviction notice, click here.
Through MaineCare (Medicaid in Maine is called MaineCare) state residents who qualify financially and medically can enroll in the Affordable Assisted Living Facility Services program. See detailed MaineCare eligibility criteria or take a short eligibility test here. Medicaid eligibility requires less than $2,382 in monthly income and less than $10,000 in countable assets. Services like medical and personal care, as well as meals and medical equipment, might be covered, but readers should be aware that Medicaid, by law, cannot pay for room and board costs associated with memory care / assisted living.
Veterans are statistically more likely to develop dementia. Relevant in all states including Maine is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an amount of money added to veterans’ and survivors’ basic pensions. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2021) maximum amount a veteran can receive through A&A is $27,540 per year, and surviving spouses can receive as much as $14,928. Learn more here.
There are also six veterans’ homes in Maine, which are residential care facilities that provide long-term care for veterans. These are located in Machias, Augusta, Bangor, Caribou, Scarborough, and South Paris. In addition to nursing home care, assisted living and memory care is provided. Payment is made directly from the VA to the facility. State veterans’ homes are typically reserved for veterans whose need for care stems at least 70 percent from their military service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there. For more, including contact information and a map with locations, click here. And for information on the services for specifically memory care, click here.
Other ways to help pay for memory care include tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that may include some assisted living costs.
A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should the spouse move from their home, the reverse mortgage would become due.
Elder care loans are for families to cover initial costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.